Research

Rosemary White-Traut, PhD, RN, FAAN, Funded Projects

 

Feeding & Transition to Home for Preterms at Social Risk

Funding Source: National Institute of Child Health and Human Development

Dates: 09/21/2007 - 07/31/2012

Co-Investigators: Kathleen Norr, Suzanne Campbell, Susan Vonderheid, Jack Zwanziger, Edward Wang

Abstract: This randomized clinical trial will test the effectiveness of H-HOPE (Hospital-home transition: optimizing prematures' environment) in improving growth and development for premature infants born at 29-34 weeks from families at high social-environmental risk. Biologic immaturity places premature infants at risk for difficulty with feeding and social interaction. Their mothers often experience increased anxiety, decreased confidence regarding infant care, and increased maladaptive mother-infant interactions. These risks greatly increase when prematurity is combined with high social-environmental risks, such as poverty, minority status, and low maternal education. H-HOPE provides intervention from 32 weeks GA to one month CA, a time when infants begin oral feeding and mothers express need for support. H-Hope is innovative because it is the first to integrate two early and evidence-based intervention components. A developmentally specific, multi-sensory intervention (auditory-tactile-visual-vestibular stimulation) helps premature infants self-regulate their behavioral state, increase pre-feeding behaviors, as well as enhancing mother-infant interaction, and decreasing length of hospital stay. Hospital and home visits, by a nurse-community health advocate team use participatory guidance to help mothers develop parenting skills specific to premature infants. 252 infants will be randomly assigned to the H-HOPE or the Attention Control groups. The H-HOPE group will have: 1) more optimal infant outcomes from birth through hospital discharge including increased pre-feeding behaviors, feeding efficiency and maturation, and hospital progression; 2) improved maternal outcomes including greater recognition of infant behavioral cues, greater confidence in infant care, more positive perception of the infant, and lower anxiety; 3) more positive mother-infant interaction and greater mother-infant contingency; 4) improved motor and mental development and growth; and 5) lower infant health care costs. Analyses employ linear and repeated measure models, controlling for recruitment site, infant factors, and social-environmental risk factors. If successful, H-HOPE will provide a national model for improving early outcomes for a highly vulnerable group. Reducing hospital stays by just 3 days for the almost 500,000 infants born prematurely could save over $2 billion annually.

Mother Administered Interventions for VLBW Infants

Funding Source: Duke University/National Institute of Nursing Research

Dates: 09/28/2005 – 07/31/2010

Abstract: Many researchers have tested in-hospital interventions to reduce the incidence of developmental problems in preterm infants. Although many have had positive short-term effects, relatively little is known about their long-term effects, the relative advantages of different types of interventions, or the effects on parenting.

This study will compare the long-term effects of two maternally administered interventions for very-low-birthweight (VLBW) preterms on infant health and development, maternal psychological well-being, and the maternal-child relationship. We will compare two interventions that have been shown to be safe and have positive short-term effects for preterms: the auditory-tactile-visual-vestibular (ATVV) intervention and kangaroo care. Administering one of these interventions will allow the mother to assume a specific role in the care of her infant in the hospital. Comparing the interventions will enable us to determine the relative importance of the direct effects of the interventions on the infant and the indirect effects through the mother that might result in improvements in maternal psychological well-being and the maternal-child relationship.

Three hundred and eighty VLBW preterms and their mothers will be recruited. Using a three-group design, they will be randomly assigned to the ATVV intervention, kangaroo care, or an attention control. Intervention nurses will instruct mothers in the intervention appropriate for their group and support them in administering it during hospitalization. Baseline data will be collected at enrollment. Outcome data will be collected at hospital discharge to determine immediate effects and at 2, 6, and 12 months corrected age to determine whether the intervention effects continue after hospitalization and affect the mother-infant relationship and infant health and developmental outcomes. Infant health and development will be measured by the length of hospitalization, growth, occurrence of health problems, and the Bayley II assessment. Maternal psychological well being will be measured using depressive symptoms, anxiety, posttraumatic stress symptoms, worry about child health, and parenting stress. The maternal-child relationship will be measured using videotapes of mother-infant interaction, the HOME Inventory, and maternal perception of child vulnerability. Cost-effectiveness of the interventions will be determined.

Harris Visiting Professorship

Funding Source: The Irving Harris Foundation

Dates: 1986 – 2011

Abstract: Since 1986, The Irving Harris Foundation has supported visiting scholars. The Irving Harris Visiting Professorship enables the Department of Women, Children and Family Health Science to invite researchers to engage in learning activities with students as well as to present their findings and clinical practice applications to clinicians and faculty from the Chicago-land area.